Zhao Jing, Dinkel Julien, Warth Arne, Penzel Roland, Reinmuth Niels, Schnabel Philipp, Muley Thomas, Meister Michael, Zabeck Heike, Steins Martin, Yang Jian-Yong, Zhou Qian, Schlemmer Heinz-Peter, Herth Felix J F, Kauczor Hans-Ulrich, Heussel Claus Peter
Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany.
PLoS One. 2017 Sep 26;12(9):e0182741. doi: 10.1371/journal.pone.0182741. eCollection 2017.
Comprehensively investigate the association of CT morphology and clinical findings of adenocarcinoma with EGFR mutation status. Retrospectively included 282 patients who was pathologically proved as lung adenocarcinoma with known EGFR mutation status (mutations: 138 patients, female: 86, median age: 66 years; wildtype: 144 patients, female: 67, median age: 62 years) and their pre-treatment CT scans were analyzed. CT findings and clinical information were collected. Univariate and multivariable logistic regression analysis were performed. Adjusted for age, gender and smoking history of two groups, significantly more patients with pleural tags, pleural and liver metastases were found in the EGFR mutated group (P = 0.007, 0.004, and 0.043, respectively). Multivariable logistic regression analysis found that the model included age, gender, smoking history, air bronchogram, pleural tags, pleural and liver metastasis had a moderate predictive value for EGFR mutation status (AUC = 0.741, P < .0001). Exon-19 deletion was associated with air bronchogram which adjusted for age, gender and smoking history (P = 0.007, OR: 2.91, 95%CI: 1.25-7.79). The evidence of pleural tags, pleural and liver metastases go along with a higher probability of EGFR mutation in adenocarcinoma patients and air bronchogram is positively associated with Exon-19 deletion mutation.
全面研究肺腺癌的CT形态学及临床特征与表皮生长因子受体(EGFR)突变状态之间的关联。回顾性纳入282例经病理证实为肺腺癌且EGFR突变状态已知的患者(突变型:138例,女性86例,中位年龄66岁;野生型:144例,女性67例,中位年龄62岁),并分析其治疗前的CT扫描图像。收集CT表现及临床信息,进行单因素及多因素逻辑回归分析。在对两组患者的年龄、性别及吸烟史进行校正后,EGFR突变组中胸膜牵拉征、胸膜及肝脏转移的患者明显更多(P值分别为0.007、0.004及0.043)。多因素逻辑回归分析发现,包含年龄、性别、吸烟史、空气支气管征、胸膜牵拉征、胸膜及肝脏转移的模型对EGFR突变状态具有中等预测价值(曲线下面积[AUC]=0.741,P<0.0001)。在对年龄、性别及吸烟史进行校正后,第19外显子缺失与空气支气管征相关(P=0.007,比值比[OR]:2.91,95%置信区间[CI]:1.25 - 7.79)。胸膜牵拉征、胸膜及肝脏转移提示腺癌患者EGFR突变概率较高,且空气支气管征与第19外显子缺失突变呈正相关。